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DEMO-17-1824
Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Perm Parcel Number Issue Da Perm t NO. DEMO-7-17-1824 Permit Type: Demolition Wok Classification: Electric Permit Status: APPROVED 711312017 Expiration: 01/14/2018 Applicant 1090 NE 104 Street Miami Shores, FL 33138- 1122320290190 Block: Lot: RICHARD E MELLETT Owner Information Address Phone Cell RICHARD E MELLETT 1090 NE 104 MIAMI SHORES FL 33138- (305)984-7069 1090 NE 104 MIAMI SHORES FL 33138- Contractor(s) AJL ELECTRIC INC Phone 305-895-4971 Cell Phone Valuation: Total Sq Feet: $ 900.00 0 Type of Demo: Electric Additional Info: REMOVE EXISTING ELECTRICAL IN WALL Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Penalty Fee Permit Fee Scanning Fee Technology Fee Work without Permit Fee Total: Amount $0.60 $2.25 $2.25 $0.20 $100.00 $150.00 $3.00 $0.80 $150.00 $409.10 Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO-7-17-64599 07/18/2017 Check #: 440 $ 359.10 $ 50.00 07/17/2017 Check* 4298 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Review Electrical In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. ma I authorize the above -named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent July 18, 2017 Date Building Department Copy July 18, 2017 1 Contact Phone#: DESIGNEJ(: Architect/>ngineer: \-A19 BUILDING PERMIT APPLICATION FBC 20 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit No. bL.S110 11- 11 14 Master Permit No. 1)t rY10 11- \ S 2 4 '`FYVED JU 7 2017 Permit Type: Electrical �n OWNER: Name (Fee Simple Titleholder): f r' C 1 e- i q la l`` ( Phone#: 3 05 9 8'i -'70 Address: / U QQ /✓C l 0 4- 3/- • City: /1'1 IA /vl (' S% O K-Cr State: � criC ✓.I A Zip: Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: / 0 9 O N C. / 0 S% City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes CONTRACTOR: Company Name: Address: /o2- S5 Q / S c.of yam/ A1/4-3- City: Qualifier Name: NO Flood Zone: ? i t n M State: FL pal i14o,1y C L--uno v�L State Certification or Registration #: E Ci /3 0 0 O irq Certificate of Competency #: ATL 8� (o @ )(p-/400, EOM 14s-/s(t'•'Z3 �LezT�i C c & 00 13-826, Email Address: Phone#: <3 Cs 8'95-- /4-CI' / /1J crr2774 A%1 //rr Ft— 33 /?�( Zip: 23/Sf p Phone#: J C� Y '7 t% 5`73� MA,2f� , -c -M Pq £ .-` �} O v Value of Work for this Permit: $ b Square/Linear Footage of Work: Phone#: Type of Work: Address ❑Alteration Description of Work: New ❑Repair/Replace (ZAr-✓Yl6f47`Flu ,S 11 dv j ( 44f �i4� i ry L & Ov1 _...Lc111-1-C'-t4- r)1C)Si7N/Ci c Ai. A-1, *emolition ******************************** *** )ty es************** *****: *** ******************* Submittal Fee $ 50 1 d Permit Fee $ %s 0/de) CCF $ CO/CC $ 1©Grd� Scanning Fee $ Radon Fee DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ 39 . (0 Bonding Company's Name (if applicable) Bonding Company's Address City . i State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City ' _ State - Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installationhas commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC , ',1 OWNER'S AFFIDAVIT: f certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. ( , "WARNING " TO OWNER: YOURS FAILURE TO RECORD A NOTICE `OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS ' TO YOUR - PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property` is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job' site for the first inspection which occurs seven (7) days after the building permit is issued.. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent Signature Jr t. / The foregoing foregoing instrument was acknowledged before me this ') The foregoing instrument was acknowledged before me this day of _. U 1all2011, by t" J G /• day of '1 c. _%--Y , 20 l-1, by , fi A% #. o ' `) L(Apo T1< who is'persony.known to me or who has produced .who is personally known to me or who has produced O • L.-- As identification and who did take an oath. as identification and who'did take an oath. NOTARY PUBLIC: Sign: Print: C 3A:S CI CANA My Commission Expir MY COMMISSION il FF 200055 EXPIRES: February 17, 2019 Bonded Thru Notary Public Underwriters NOTARY PUBLIC: Sign. Print: My-Commissi ****************************************************,k.k***************i************************************** 1r ,f APPROVED BY W.,"/V>2 % )'.YUG,y.i }r Plans Examiner . Zoning Structural Review _ Clerk (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) STATEOF FLORIDA DEPARTMENTRtCA$L Ir ' R L SING BOARDuk T10N LICENSE NUMBER The ELECTRICAL CONTRACTOR Name jbel_oW IS CERTIF_IFn Un6er the phzdai ns 6,_Cha tar 489 FS. Expiratoon date: AUG 3-1; 2018 • LUPQ, AN{+IQNY7 -:= A J 1. exafRLC IN.C- I265513ISCA NORTHMI-AM ISSUED: 0726/2016 DISPLAY AS REQUIRED BY LAW SEO L1607260001567 i wuTH1MIAMI F L II I' I El A City of North Miami 776 N.E.125 Street • North Miami, FL 33161 • 305-893-6511 Business Tax/Certificate of Use Receipt Issued Date: 10/1/2016 Expiration Date: 9/30/2017 Business Tax Receipt #: BT-002364 A J L ELECTRIC, INC. 12555 BISCAYNE BLVD BOX 826 NORTH MIAMI, FL 33181 ELECTRICAL CONTRACTOR Business Name / Address: A J L ELECTRIC, INC. 12555 BISCAYNE BLVD, BOX 826 NORTH MIAMI, FL 33181 Michael A. Etienne, Esquire, City perk NOTICE: BUSINESS TAX RECEIPT MUST BE TRANSFERED WHEN BUSINESS IS MOVED OR SOLD. NON -TRANSFERABLE • POST IN A CONSPICUOUS PLACE • NON -TRANSFERABLE 001304 Local Business Tax Receipt Miami —Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 1929745 BUSINESS NAMEILOCATION AIL ELECTRIC INC 12408 N BAYSHORE DR NORTH MIAML FL 33181.. OWNER AIL ELECTRIC INC Worker(s) 1 RECEIPT NO. RENEWAL 2037000 LBT EXPIRES SEPTEMBER 30, 2017 Must be displayed at place of business Pursuant-toCountyCode Chapter 8A — Art 9 & 10 SEC. TYPE OF BUSINESS 196 ELECTRICAL CONTRACTOR EC13002089 PAYMENT RECEIVED BY TAX COLLECTOR $45.00 09/13/2016 ,nenrreann to ncven AJLEL-1 OP ID: TR /_'1 _ ,4`oEzv CERTIFICATE OF LIABILITY INSURANCE I DATE (MMNDnm Y 05/09/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. AND CONFERS NO RIGHTS UPON THE CERTIFICATE EXTEND OR ALTER THE COVERAGE AFFORDED HOLDER. THIS BY THE POUCIES AUTHORIZED A CONTRACT BETWEEN THE ISSUING INSURER(S), IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does riot confer rights to the holder in Ileu of such endorsement(s). certificate PRODUCER Roebuck Associates Insurance Exchange LLC 5599 S University Drive, # 301 Davie,INSUREWS) Associates Roebubuckk Associates CONTACT NAME: PHONE FAX (AIG. No. Eat (AC. No) E-MAILADDRE s AFFORDING COVERAGE NAIC • ,NsURER A : Wesco Insurance Company INSURED AJL Electric Inc. 12408 N. Bayshore Drive N. Miami Beach, FL 33181 - INSURER B : Normandy Insurance Co INsukER c :United States Liability Ins Co INSURER D : INSURER E : INSURER F : nnncrneT MI IMIQCD• COVERAGES GERTIFIGAI t NUIIIIDCK: ------- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRPOUCY TYPE OF INSURANCE ADD A 1AN R NI B POUCY NUMBER EFF (MMIDDIYYYY) (MMIDINYYVY1 POLICY EXP WAITS LTR STIR EACH OCCURRENCE $ 1,000,000 GENERAL L.IABD ff Y WPP114875703 05/152017 05/15/2018 DAMAGETDR 'im-D PREMISES (Ea owsrenca) $ 100,000 A X COMMERCIAL GENERAL L.IABIUI'Y 5,000 CLAIMS -MADE X OCCUR MED EXP (Arty one person) $ 1,000,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 • PRODUCTS = COMP/OP AGG $ GEN'L AGGREGATE UNIT APPLIES PER 50 n 7,n LOC $ POLICY COMBINED SINGLE UMIT acciden0 $ AUTOMOBILE LIABILITY(Ea BODILY INJURY (Per persat) $ ANY AUTO All OW NED _ SCHEDULED BODILY INJURY (Per accident) $ AUTOS NAUTOS ON -OWNED PROPERTY DAMAGE (PER ACCIDENT) $ HIRED AUTOS AUTOS $ EACH OCCURRENCE f 2,000,000 UMBRELLA LIAB X OCCUR XL1566070B 05/18/2017 05/18/2018 AGGREGATE $ 2,000,000 C X EXCESSUAB CLAIMS -MADE I RETENTIONS $ DED COMPENSATION X WC STATU- TORY UMTS OTH- ER WORKERS AND EMPLOYERS' LABILITY Y� NHFL006628201 T 05N 5/2017 05/1512018 EA_ EnCtl ACCIDENT $ 1,000,000 - B ANY PROPRIETCAUPXCLUDE/EXECUTIVE OFFICER/MEMBERlyNH) EXCLUDED? N 1 A E.L DISEASE - EA EMPLOYEE $ 1,000,000 .-. (Mandatory In NH) yea, describe under below EDISEASE - POLICY LIMIT J_ $ 1,000,000 D DESCRIPTIONIf OPERATIONS DESCRIPTION EC13002089 OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schsdtde, N more spats Is required) ... ....e, . .re,u CERTIFICATE HOLDER Miami Shores Village Building Dept. 10050 NE 2 Avenue - Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WLL BE DEUVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) 01988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD